فصلنامه بیماری های پستان ایران
سال پانزدهم شماره 3 (پیاپی 58، پاییز 1401)

Self-efficacy and people's satisfaction with breast self-examination training methods are very important in creating and perpetuating this breast cancer screening behavior. Therefore, choosing the most appropriate educational approach is important. The aim of this study was to Comparing the self-efficacy of breast self-examination and satisfaction with training in both face-to-face and smartphone-based training methods.

In this randomized controlled trial, 70 women referring to the breast clinic in Rafsanjan were selected by available methods and by drawing samples assigned to two groups of face-to-face and smartphone-based training. Training was done in both groups individually. The training in the face-to-face group was through lectures with PowerPoint, and for the smartphone-based group by uploading a training video on WhatsApp. Data were collected before and immediately after the intervention through individual characteristics checklist, satisfaction questionnaire and self-efficacy questionnaire and analyzed by SPSS22 software and independent t-test, paired t-test, chi-square, analysis of covariance and Fisher's exact test.

The mean scores of self-efficacy in the two groups of face-to-face and smartphone-based training, before the intervention were 22/57±4/68 and 20/68±5/08, and immediately after the intervention were 33/57±4/47 and 29/59±6/14, respectively. Satisfaction with training in the two groups of face-to-face and smartphone-based training was 173/78±7/18 and 166/46±17/86, respectively. Covariance analysis results showed a significant difference between the two groups in the degree of self-efficacy score (P = 0.007).

Both face-to-face and smartphone-based training methods provide satisfaction with training and create appropriate self-efficacy for breast self-examination, and face-to-face training has better results in this area.

Breast cancer is a multifactorial disease, and steroid hormones, especially estrogens and progesterone, are among the most important risk factors. Some conditions such as pregnancy, early menarche, late age at first full-term pregnancy, and use of oral contraceptive pills (OCPs), which increase the risk of estrogen exposure, also increase the risk of breast cancer. This study aimed to evaluate OCP use–related hormonal changes as a risk factor for breast cancer in young women in Najaf.

This cross-sectional study was conducted on 75 breast cancer patients and 25 healthy women between January and June 2021 at Al-Sader Teaching Hospital and the Middle Euphrates Cancer Center in Najaf city, Iraq. After obtaining written informed consent, the researchers drew 5 ml of venous blood from each participant and analyzed the samples using the cobas® e 411 analyzer. Estrogen and progesterone serum levels were measured to evaluate the relationship between the use of OCPs and breast cancer.

The mean serum level of estrogen in breast cancer patients with and without a history of OCP use (159.80 pg/ml 168.23 pg/ml, respectively) was significantly higher compared with the control group (95.48 pg/ml). The mean serum levels of progesterone in patients with and without a history of OCP use were 4.9 and 4.12 pg/ml, respectively, which in users was higher than in the control group (4.3 pg/ml, P = 0.01).

This study found that using OCPs was associated with a higher risk for breast cancer. This issue can be considered in health policies to control breast cancer incidence.

Breast cancer is the most common type of cancer in women. Garlic and ginger have been widely studied as antioxidant agents. In this study, we investigated the combined effect of garlic and ginger on BALB/c mice with breast cancer.

Breast tumor–bearing female mice were divided into 7 groups: 1 group receiving normal saline, 2 groups receiving different doses of ginger extract (100 and 500 mg/kg), 2 groups receiving garlic extract (50 and 100 mg/kg), 1 group receiving tamoxifen (10 mg/kg), and 1 group receiving garlic (100 mg/kg) and ginger (500 mg/kg) together. The treatments were administered intraperitoneally for 3 weeks. After this period, the size of tumor, glutathione transferase levels, and expression of ABCG2 and SPARC genes were measured.

Tumor size significantly decreased in all groups. The level of glutathione transferase increased in all groups, and this increase was significant except in the groups receiving garlic and ginger at a dose of 100 mg/kg. The expression of SPARC, a biomarker for cancer, was significantly reduced in all groups. The expression of ABCG2, encoding the breast cancer resistance protein, decreased in all groups, and this decrease was significant in groups receiving garlic at 50 mg/kg and tamoxifen.

Garlic and ginger can be useful in the treatment of cancer. This anticancer action is probably mediated through the antioxidant mechanism and inhibition of the expression of genes responsible for drug resistance in cancer. The simultaneous use of garlic and ginger did not produce a synergistic effect. Therefore, further studies are needed to determine the required doses as well as the mechanisms of this action.

 Breast cancer is the most common cancer in Iran. Delay in diagnosis is one of the causes of increased mortality in these patients. There are several obstacles to achieving an early diagnosis. This study seeks to identify the social determinants influencing breast cancer diagnosis.

This qualitative study was conducted at Reza Oncology Clinic in Mashhad in 2019-2020. The study sample included 21 patients with breast cancer selected via purposive sampling. Data were collected using semi-structured in-depth interviews. Data were recorded, handwritten, and coded, subthemes were identified, and then the original themes were refined. By integrating the subthemes, they became the main themes.

Economic status, life crises, social support, stigma, family history of cancer, fateful beliefs, preventive behavior, disease recognition, role conflicts, gender inequalities, and access to medical opportunities were the social factors mentioned in the narratives.

This study has shown that social, cultural, and economic factors influence breast cancer diagnosis. Therefore, any effort to improve disease diagnosis requires a multidisciplinary approach that addresses biomedical, social, cultural, and economic factors simultaneously.

Breast cancer, as the most common cancer, is the cause of death of millions of people around the world. Given that psychological status can be effective in responding to treatment by affecting the immune system, the aim of this study was to present a model for predicting the status of the immune system through personality type D mediated by defense mechanisms in patients with breast cancer.

The statistical population of the present study included all women with breast cancer in Tehran and Gilan in 1398, from which 250 were selected by purposive sampling. Data were collected using a Type D personality, Questionnaire Defense Style Questionnaire and Warning Signs of Immunodeficiency. Pearson correlation coefficient and structural equation modeling were used to analyze the data using AMOS and SPSS software version 22.

The results showed that there was a significant and direct correlation between the status of the immune system and the neurotic defense mechanism, undeveloped defense mechanism and personality type D and a significant and inverse correlation between the status of the immune system and the developed defense mechanism. Also, defense mechanisms played a mediating role in the relationship between personality type D and immune system status in breast cancer patients.

Accordingly, in patients with breast cancer, the status of the immune system can be predicted through defense mechanisms and personality type D. Therefore, therapists and health professionals can help these people overcome their disease by designing interventions based on modifying defense mechanisms and personality type D. Thus, the more an individual uses the immature defense mechanism, the weaker the immune system is, and the use of the developed defense mechanism is associated with a stronger immune system. Based on the findings, it can be said that designing psychological interventions based on modifying defense mechanisms and changing personality type D, can help a patient with breast cancer to manage and treat the disease.

Breast reconstruction surgery is one of the options available for reducing the psychological effects of mastectomy, improving body image, and alleviating the psychosocial conditions of breast cancer survivors. Family structure and communication with friends and community members deeply affect the type and severity of problems faced by individuals. The aim of this study was to determine the relationship between family social support and the attitude of mastectomy patients toward breast reconstruction surgery.

This descriptive-analytical study was performed on 137 breast cancer patients who had undergone mastectomy. Patients referred to Omid Hospital in Mashhad who met the criteria for entering the study were selected using the convenience sampling method in the fall of 2017. Data were collected using a standard questionnaire for assessing attitudes towards breast reconstruction surgery after mastectomy (including 21 items with binary answers of “I agree” and “I disagree”) and the Perceived Social Support from Family Scale (including 20 items with answers of “yes,” “no,” and “don’t know”). The data were analyzed using descriptive and inferential statistics.

The mean scores for attitude towards breast reconstruction and social support were 17.14 ± 2.35 and 14.75 ± 2.85, respectively, which shows that the patients under study had a favorable level of social support. There was a significant relationship between social support from family and attitude towards breast reconstruction (r = 0.17, P = 0.04). There were significant differences in attitude towards breast reconstruction among participants with different levels of education and number of children (P = 0.03 and P = 0.01, respectively), while significant differences were observed in perceived social support from family for variables of education and economic status (P = 0.01, P = 0.003, respectively). No significant relationship was found between other individual characteristics and either social support or attitude.

By making women aware of the challenges and benefits of breast reconstruction, a positive attitude towards reconstruction can be created in them so that they can experience a successful reconstruction by accepting the support of those around them, and their quality of life after cancer can improve.

Breast cancer is the most common malignant tumor in women. P53 is the most frequently altered gene in breast cancer. This study aimed to evaluate the correlation of the immunohistochemical expression of P53 protein with age and histopathological variables in breast cancer patients.

This cross-sectional study was conducted on 40 women with breast cancer referred to the Middle Euphrates Unit for Cancer Research, Najaf, Iraq, from January 2019 to April 2021. Pathologists from different diagnostic centers in Najaf province examined tumor histopathological characteristics, including histological type, grade of tumor, expression of the p53 protein, and ERBB2 (HER2/neu) on 40 blocks of paraffin-fixed breast tumor samples. The association between p53 expression and each of the other variables was assessed using the chi-square test.

Most participants were in the age group 50-59 years (47.5%). The highest percentage of the p53 protein positivity was found in the age group ≥50 years (75%), tumor grade 2, 3 (50%, 33.3%), invasive ductal carcinoma (91.7%), and HER2-negative group (75%). The expression of p53 was not significantly correlated to any of the investigated variables.

It may be possible to use p53 immunohistochemical expression to predict treatment response or disease progression in breast cancer. However, the value of examining p53 in the follow-up periods of patients or using it in treatment protocols requires more studies.